Fones C, Tsoi W F
Department of Psychological Medicine, National University Hospital, Singapore.
Br J Clin Pract. 1995 Mar-Apr;49(2):97-9.
A patient with polycythaemia rubra vera is described, presenting primarily with symptoms attributed to depression. While in the ward she developed a stroke, confirmed on CT scan of the head. Venesection alone produced marked improvement in her neurological and psychiatric symptoms. The clinical picture corresponds most accurately to the neurological syndrome of abulia, which is an important differential diagnosis of depression with psychomotor retardation. The pathophysiology of impaired cerebral blood flow causing neuropsychiatric symptoms in polycythaemia is discussed.
本文描述了一位真性红细胞增多症患者，其最初表现为归因于抑郁症的症状。在病房期间，她发生了中风，头部CT扫描得以证实。仅通过放血治疗，其神经和精神症状就有了显著改善。临床表现最符合无动性缄默症的神经综合征，这是伴有精神运动迟缓的抑郁症的重要鉴别诊断。文中讨论了真性红细胞增多症中脑血流受损导致神经精神症状的病理生理学。
